J Pediatr Intensive Care 2020; 09(03): 172-180
DOI: 10.1055/s-0040-1705181
Original Article
Georg Thieme Verlag KG Stuttgart · New York

High-Dose Vasopressor Therapy for Pediatric Septic Shock: When Is Too Much?

Paulo Sérgio Lucas da Silva
1  Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil
Marcelo Cunio Machado Fonseca
2  Health Technologies Assessment Center, Federal University of São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

10 November 2019

27 January 2020

Publication Date:
09 March 2020 (online)


It is unknown if the requirement for high dose of vasopressor (HDV) represents a poor outcome in pediatric septic shock. This is a retrospective observational analysis with data obtained from a single center. We evaluated the association between the use of HDV and survival in these patients. A total of 62 children (38 survivors and 24 nonsurvivors) were assessed. The dose of vasopressor (hazard ratio 2.06) and oliguria (hazard ratio 3.17) was independently associated with mortality. The peak of vasopressor was the best prognostic predictor. A cutoff of 1.3 μg/kg/min was associated with mortality with a sensitivity of 75% and specificity of 89%. Vasopressor administration higher than 1.3 μg/kg/min was associated with increased mortality in children with septic shock.